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The role of PBT in hOMC has been studied in many retrospective cohort studies. Although there is a plethora of evidence on photon-SBRT, there are very few analyses on the role of PBT in hOMC. The author intends to analyse the efficacy in terms of the local control (LC) and the overall survival (OS) for PBT and its toxicity profile in this systematic review. LC remains persistently high (76\u201389% at 1\u20132 years) across breast, colo-rectum, stomach, and esophagus. Sites like colo-rectum and breast show relatively better survival outcomes, with progression free survival (35\u201352% at 1\u20132 years) and OS (33\u201378% at 1\u20132 years) than other sites, likely due to disease biology. Breast primary derived hOMCs had the best 3-year OS of 67.6%. Toxicities remain remarkably low with grade 3 plus toxicities ranging from 0\u20133%, which reflects the ability of proton therapy to deliver beams with precision.<\/jats:p>","DOI":"10.15388\/amed.2025.32.1.25","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T23:46:02Z","timestamp":1750808762000},"page":"36-51","source":"Crossref","is-referenced-by-count":0,"title":["Role of Proton Beam Therapy in Hepatic Oligometastasis: Review of Evidence"],"prefix":"10.15388","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3905-4922","authenticated-orcid":false,"given":"Satyajeet","family":"Rath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6097","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Izmailov T, Ryzhkin S, Borshchev G, Boichuk S. 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Phys Imaging Radiat Oncol. 2018;8:17-22. doi:10.1016\/j.phro.2018.11.004","DOI":"10.1016\/j.phro.2018.11.004"},{"key":"ref75","doi-asserted-by":"publisher","unstructured":"Parkes MJ, Green S, Cashmore J, Stevens AM, Clutton-Brock TH, Bel A, Lens E, Lohr F, Boda-Heggemann J. In Regard to Boda-Heggemann et al. Int J Radiat Oncol Biol Phys. 2016;96(3):709-710. doi:10.1016\/j.ijrobp.2016.07.001","DOI":"10.1016\/j.ijrobp.2016.07.001"},{"key":"ref76","doi-asserted-by":"publisher","unstructured":"Engelsman M, Schwarz M, Dong L. Physics controversies in proton therapy. Semin Radiat Oncol. 2013;23(2):88-96. doi:10.1016\/j.semradonc.2012.11.003","DOI":"10.1016\/j.semradonc.2012.11.003"},{"key":"ref77","doi-asserted-by":"publisher","unstructured":"De Ruysscher D, Sterpin E, Haustermans K, Depuydt T. Tumour movement in proton therapy: solutions and remaining questions: a review. Cancers (Basel). 2015;7(3):1143-1153. doi:10.3390\/cancers7030829","DOI":"10.3390\/cancers7030829"},{"key":"ref78","doi-asserted-by":"publisher","unstructured":"Taunk NK, Burgdorf B, Dong L, Ben-Josef E. Simultaneous Multiple Liver Metastasis Treated with Pencil Beam Proton Stereotactic Body Radiotherapy (SBRT). Int J Part Ther. 2021;8(2):89-94. doi:10.14338\/IJPT-20-00085.1","DOI":"10.14338\/IJPT-20-00085.1"},{"key":"ref79","doi-asserted-by":"publisher","unstructured":"Mondlane G, Ureba A, Gubanski M, Lind PA, Siegbahn A. Estimation of the risk for radiation-induced liver disease following photon- or proton-beam radiosurgery of liver metastases. 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